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https://www.readbyqxmd.com/read/29909558/blood-brain-barrier-permeability-assessed-by-perfusion-computed-tomography-predicts-hemorrhagic-transformation-in-acute-reperfusion-therapy
#1
Taewon Kim, Jaseong Koo, Seong-Hoon Kim, In-Uk Song, Sung-Woo Chung, Kwang-Soo Lee
Hemorrhagic transformation (HT) is one of the most feared complications of acute recanalization therapies. The aim of this study was to evaluate whether blood-brain barrier permeability (BBBP) imaging can predict HT in the setting of acute recanalization therapy and to determine the sensitivity and specificity of BBBP for the prediction of HT according to the type of reperfusion therapy. We assessed a total of 46 patients who received recanalization therapy (intravenous (IV) recombinant tissue plasminogen activator (tPA), mechanical thrombectomy with a stent retriever or both) for acute ischemic stroke within the internal carotid artery or middle cerebral artery...
June 16, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29909454/inhibition-of-toll-like-receptor-4-tlr-4-improves-neurobehavioral-outcomes-after-acute-ischemic-stroke-in-diabetic-rats-possible-role-of-vascular-endothelial-tlr-4
#2
Yasir Abdul, Mohammed Abdelsaid, Weiguo Li, R Clinton Webb, Jennifer C Sullivan, Guangkuo Dong, Adviye Ergul
Diabetes increases the risk of occurrence and poor functional recovery after ischemic stroke injury. Previously, we have demonstrated greater hemorrhagic transformation (HT), edema, and more severe functional deficits after stroke in diabetic animals that also presented with cerebral vasoregression and endothelial cell death in the recovery period. Given that Toll-like receptor 4 (TLR-4) activation in microvascular endothelial cells triggers a robust inflammatory response, we hypothesized that inhibition of TLR-4 signaling prevents endothelial cell death and improves outcomes after stroke...
June 16, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29909213/pipeline-embolization-device-flow-diversion-for-a-dissecting-ruptured-posterior-cerebral-artery-aneurysm-in-a-pediatric-patient
#3
Murillo Cunegatto-Braga, Brian Hogan, Pedro Aguilar-Salinas, Alexandra D Beier, Ricardo A Hanel
BACKGROUND: Intracranial aneurysms(IAs) are rare in the pediatric population and are usually considered difficult to treat with traditional microsurgery due to their complex morphology. Endovascular techniques have become the standard option for treating IAs in adults. More recently, flow diverters such as the Pipeline Embolization Device(PED) are being widely adopted for unruptured IAs with safety and efficacy in adults, yet their use in the pediatric population is not well defined. In this paper we present a pediatric patient with a ruptured PCA aneurysm successfully treated with a PED and a review of the literature of the current status of PED use in this subset of patients...
June 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29908849/cephalic-region-war-injuries-in-children-experience-in-french-nato-hospital-in-kabul-afghanistan
#4
Hussam El Chehab, Emilie Agard, Corinne Dot
BACKGROUNDS: The NATO KAIA Hospital (Kabul International Airport), under French command, provided medical support for NATO forces in the Kabul region from 2009 to 2014. Medical assistance to civilians was an additional mission which included support for children who were war injured. The objective of this study was to analyze characteristics of cephalic injuries in children victims of war trauma. METHODS: A retrospective study was conducted and commenced with the hospital opening (July 2009) to March 2012 on all children (<15years) with war trauma...
June 9, 2018: Injury
https://www.readbyqxmd.com/read/29908698/delayed-hemorrhagic-complication-after-complete-embolization-of-a-brain-arteriovenous-malformation
#5
E C N Sy, A Melot, L Troude, M Al-Falasi, H Brunel, P-H Roche
Endovascular embolization is an essential therapeutic approach in the multidisciplinary management of cerebral arteriovenous malformations (AVM). However, it rarely occludes the AVM in its entirety. It is often combined with surgery or stereotactic radiosurgery. The aim of embolization is to reduce the size of the nidus and the intra-nidal flow in order to facilitate the microsurgical or the radiosurgical procedure. We report the case of a 61-year-old patient with a right frontal hemorrhagic AVM treated with complete embolization in a single session...
June 13, 2018: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29908380/the-impact-of-extubation-failure-in-patients-with-good-grade-subarachnoid-hemorrhage
#6
Jann F Wojak, Claudia Ditz, Abdulkareem Abusamha, Emma Smith, Jan Gliemroth, Volker Tronnier, Jan Küchler
OBJECTIVE: The aim of this study was to analyze the clinical impact of extubation failure (EF) in with good grade subarachnoid hemorrhage (SAH), in which a good clinical course is usually expected. PATIENTS AND METHODS: We reviewed the clinical data from 141 patients with SAH and i. initial Hunt & Hess grade 1-3 ii. induction of general anesthesia for intervention and iii. the presence of data about the functional outcome. Patients were divided into three groups: 1...
June 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29907853/monitoring-cerebral-oxygenation-of-the-immature-brain-a-neuroprotective-strategy
#7
REVIEW
Frank van Bel, Jonathan P Mintzer
Monitoring of cerebral oxygenation (rScO2 ) with near-infrared spectroscopy (NIRS) is a feasible noninvasive bedside technique in the NICU. This review discusses the possible neuroprotective role of "pattern recognition" of NIRS-derived rScO2 in preterm neonates with regard to the prevention of severe intraventricular hemorrhage and hypoxia/hyperoxia-related white matter injury. This neuroprotective role of rScO2 monitoring is discussed as a modality to aid in the early detection of cerebral oxygenation conditions predisposing to these complications...
June 15, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29907166/comparison-of-serial-blood-collection-by-facial-vein-and-retrobulbar-methods-in-c57bl-6-mice
#8
Jennifer R Frohlich, Christina N Alarcón, Camille R Toarmino, Anna K Sunseri, Tyler M Hockman
Many biomedical research protocols for mouse models involve serial blood collection and analysis. Two common techniquesfor serial blood collection in this species are the retrobulbar (RB, also called retroorbital) and facial vein (FV) methods. However, previous studies comparing these methods typically evaluated collection at a maximum of 2 time points. Here we compared hematologic values, adverse clinical effects, and histopathologic lesions in mice bled either once or serially (6 times) by using the FV or RB method...
June 15, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/29905510/bleeding-risk-of-cerebral-cavernous-malformations-in-patients-on-%C3%AE-blocker-medication-a-cohort-study
#9
Johannes Goldberg, Christian Jaeggi, Daniel Schoeni, Pasquale Mordasini, Andreas Raabe, David Bervini
OBJECTIVE Cerebral cavernous malformations (CCMs) are frequently diagnosed vascular malformations of the brain. Although most CCMs are asymptomatic, some can be responsible for intracerebral hemorrhage or seizures. In selected cases, microsurgical resection is the preferred treatment option. Treatment with the unselective β-blocker propranolol has been presumed to stabilize and eventually lead to CCM size regression in a limited number of published case series; however, the underlying mechanism and evidence for this effect remain unclear...
June 15, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29904350/unique-contribution-of-haptoglobin-and-haptoglobin-genotype-in-aneurysmal-subarachnoid-hemorrhage
#10
REVIEW
Spiros L Blackburn, Peeyush T Kumar, Devin McBride, Hussein A Zeineddine, Jenna Leclerc, H Alex Choi, Pramod K Dash, James Grotta, Jaroslaw Aronowski, Jessica C Cardenas, Sylvain Doré
Survivors of cerebral aneurysm rupture are at risk for significant morbidity and neurological deficits. Much of this is related to the effects of blood in the subarachnoid space which induces an inflammatory cascade with numerous downstream consequences. Recent clinical trials have not been able to reduce the toxic effects of free hemoglobin or improve clinical outcome. One reason for this may be the inability to identify patients at high risk for neurologic decline. Recently, haptoglobin genotype has been identified as a pertinent factor in diabetes, sickle cell, and cardiovascular disease, with the Hp 2-2 genotype contributing to increased complications...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29903733/t-cells-prevent-hemorrhagic-transformation-in-ischemic-stroke-by-p-selectin-binding
#11
Angélica Salas-Perdomo, Francesc Miró-Mur, Xabier Urra, Carles Justicia, Mattia Gallizioli, Yashu Zhao, Vanessa H Brait, Carlos Laredo, Raúl Tudela, Andrés Hidalgo, Ángel Chamorro, Anna M Planas
OBJECTIVE: Hemorrhagic transformation is a serious complication of ischemic stroke after recanalization therapies. This study aims to identify mechanisms underlying hemorrhagic transformation after cerebral ischemia/reperfusion. APPROACH AND RESULTS: We used wild-type mice and Selplg-/- and Fut7-/- mice defective in P-selectin binding and lymphopenic Rag2-/- mice. We induced 30-minute or 45-minute ischemia by intraluminal occlusion of the middle cerebral artery and assessed hemorrhagic transformation at 48 hours with a hemorrhage grading score, histological means, brain hemoglobin content, or magnetic resonance imaging...
June 14, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29902610/modified-extended-suboccipital-subtonsillar-clipping-of-a-ruptured-proximal-pica-aneurysm-technical-note-with-relevant-anatomical-demonstration
#12
Alberto Di Somma, Paloma Cancela, Magdalena Olivares, Teresa Somma, Antonio López-González, Alvaro Campero, Juan Emmerich, Javier Márquez-Rivas
BACKGROUND: and importance: Lesions located lateral to the lower brainstem, such as proximal posterior inferior cerebellar artery (PICA) aneurysms, are surgically challenging. In this study we report a case of a patient with a left proximal PICA aneurysm that was successfully clipped via a so-called "extended" suboccipital subtonsillar approach, which allowed to obtain proper vascular control without removal of the atlas. The anatomy relevant for this approach has been studied...
June 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29902601/study-of-correlation-between-hp-%C3%AE-1-expression-of-haptoglobin2-1-and-clinical-course-in-aneurysmal-subarachnoid-hemorrhage
#13
Bong Jun Kim, Youngmi Kim, Sung-Eun Kim, Jin Pyeong Jeon
OBJECTIVE: Haptoglobin (Hp) comprising two light (α) and two heavy (β) chains has an anti-oxidant effect following free hemoglobin binding. Among three phenotypes including Hp1-1 (two α1), Hp2-1 (α1 and α2), and Hp2-2 (two α2), a higher protective effect for toxic-free hemoglobin was reported for Hp2-2 than Hp1-1. However, few studies have focused on Hp2-1 in outcome. This study examined the α1 and α2 expression, and evaluated the correlation of Hp2-1 with subarachnoid hemorrhage (SAH) outcome...
June 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29898970/alcohol-intake-and-the-risk-of-intracerebral-hemorrhage-in-the-elderly-the-much-italy
#14
Paolo Costa, Mario Grassi, Licia Iacoviello, Marialuisa Zedde, Simona Marcheselli, Giorgio Silvestrelli, Maria Luisa DeLodovici, Maria Sessa, Andrea Zini, Maurizio Paciaroni, Cristiano Azzini, Massimo Gamba, Massimo Del Sette, Antonella Toriello, Carlo Gandolfo, Domenico Marco Bonifati, Rossana Tassi, Anna Cavallini, Alberto Chiti, Rocco Salvatore Calabrò, Francesco Grillo, Paolo Bovi, Giampaolo Tomelleri, Augusto Di Castelnuovo, Marco Ritelli, Giancarlo Agnelli, Alessandro De Vito, Nicola Pugliese, Giuseppe Martini, Corrado Lodigiani, Andrea Morotti, Loris Poli, Valeria De Giuli, Filomena Caria, Claudio Cornali, Giovanni de Gaetano, Marina Colombi, Alessandro Padovani, Alessandro Pezzini
OBJECTIVE: To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding. METHODS: We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014...
June 13, 2018: Neurology
https://www.readbyqxmd.com/read/29895534/neurologic-outcome-predictors-in-pediatric-intracerebral-hemorrhage-a-prospective-study
#15
Giulia S Porcari, Lauren A Beslow, Rebecca N Ichord, Daniel J Licht, Jonathan T Kleinman, Lori C Jordan
BACKGROUND AND PURPOSE: Intracerebral hemorrhage is a considerable source of morbidity and mortality. This 3-center study describes outcomes of pediatric intracerebral hemorrhage and identifies 2-year neurological outcome predictors. METHODS: Children 29 days to 18 years of age presenting with intracerebral hemorrhage from March 2007 to May 2015 were enrolled prospectively. Exclusion criteria included trauma; intracranial tumor; hemorrhagic transformation of arterial ischemic stroke or cerebral sinovenous thrombosis; isolated subdural, epidural, or subarachnoid hemorrhage; and abnormal baseline neurological function...
June 12, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29895533/characterization-of-heterozygous-htra1-mutations-in-taiwanese-patients-with-cerebral-small-vessel-disease
#16
Yi-Chung Lee, Chin-Ping Chung, Nai-Chen Chao, Jong-Ling Fuh, Feng-Chi Chang, Bing-Wing Soong, Yi-Chu Liao
BACKGROUND AND PURPOSE: Homozygous and compound heterozygous mutations in the high temperature requirement serine peptidase A1 gene ( HTRA1 ) cause cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy. However, heterozygous HTRA1 mutations were recently identified to be associated with autosomal dominant cerebral small vessel disease (SVD). The present study aims at investigating the clinical features, frequency, and spectrum of HTRA1 mutations in a Taiwanese cohort with SVD...
June 12, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29895187/factor-viii-in-acute-cerebral-ischemia-pilot-study-biomarker-in-patients-with-large-vessel-occlusion
#17
Digvijaya Navalkele, Amelia Boehme, Karen Albright, Cindy Leissinger, Laurie Schluter, Melissa Freeman, Stacy Drury, Ramy El Khoury, T Mark Beasley, Sheryl Martin-Schild
We conducted a prospective serial laboratory cohort study to assess the correlation of factor VIII (FVIII) levels in response to thrombolysis in patients with large vessel occlusion (LVO) and acute ischemic stroke (AIS). Patients with AIS with anterior circulation LVO were eligible for enrollment if treated within 4.5 hours from last seen normal with intravenous tissue plasminogen activator (tPA). Patients (n = 29) had a mean age of 71 years and median National Institute of Health Stroke Scale of 14. Baseline pre-tPA FVIII was not significantly correlated with clot burden score (-0...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29894445/cerebral-amyloid-angiopathy-a-different-kind-of-stroke
#18
Lisa Ruth-Sahd, Melissa Schneider
When a patient presents with stroke-type symptoms, the correct diagnosis is imperative to determine appropriate treatment. Cerebral amyloid angiopathy (CAA), a buildup of amyloid proteins on the brain artery walls, is a cause of intracerebral hemorrhage. Improved diagnostic criteria and enhanced neuroimaging have resulted in earlier detection of CAA, which will hopefully lead to better outcomes for these patients. More research is being conducted, and neuroscience nurses need to stay informed about this condition to be able to appropriately care for and educate their patients who are diagnosed with CAA...
June 12, 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29892260/bedsided-transcranial-sonographic-monitoring-for-expansion-and-progression-of-subdural-hematoma-compared-to-computed-tomography
#19
Wolf-Dirk Niesen, Michael Rosenkranz, Cornelius Weiller
Introduction: Transcranial high-resolution ultrasonography reliably allows diagnosis and monitoring of intracerebral hemorrhage in adults. Sonographic monitoring of subdural hematoma (SDH) has not been evaluated in adults so far. This study investigates the reliability of transcranial gray-scale sonography (TGS) in monitoring acute and chronic SDH in adults. Methods: TGS was performed in 47 consecutive patients with either acute or chronic SDH confirmed by cerebral CT...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29891028/early-carotid-artery-stenting-after-onset-neurologic-symptoms
#20
Gianmarco de Donato, Francesco Setacci, Edoardo Pasqui, Domenico Benevento, Giancarlo Palasciano, Antonio Sterpetti, Luca di Marzo, Carlo Setacci
Multicenter clinical trials level 1 evidence favors the application of carotid endarterectomy in symptomatic patients, especially the in the elderly cohort. Carotid artery stenting has been proposed as a possible early alternative in selected patients after onset of ipsilateral neurologic symptoms. It is well known that treatment of acute stroke is time-dependent in patients with acute ischemic stroke caused by high-grade stenosis of the internal carotid artery, but intensive medical treatment in conjunction with intervention to improve stroke severity and clinical outcomes has not been established...
March 2018: Seminars in Vascular Surgery
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